MQ Mental Health Science Meeting Live Blog 2018

Welcome to the live blog for the 2018 MQ Mental Health Science Meeting. We join you from the Barbican Centre in London as researchers, clinicians and members of the mental health community are taking their places ahead of what promises to be an inspiring event.

The theme of this year’s meeting is 'Towards Prevention and Early Intervention' and over the course of the next two days, we will be hearing from cutting-edge researchers from a range of disciplines.

Be sure to check in throughout the meeting for highlights and summaries from all of our fantastic speakers and remember that you can tweet us with the hashtag#MQScienceMeeting with any of your thoughts.

Save the date for our next Mental Health Science Meeting, it's happening on the 7th and 8th of February 2019!

Friday 2nd February 2018

16:15 – Final Words

Now its Sophie Dix to close the days proceedings, who starts by thanking all of those involved in the organisation of the meeting.

Sophie discusses some of MQ’s successes over the last year. MQ is now funding over 36 new research projects and is receiving more and more in charitable donations with each month that goes by.

Sophie now goes on to thank Cynthia Joyce, MQ’s Chief Executive, who will soon be moving to the USA to spread MQ’s message to a global audience. Lindsey Bennister will start as MQ’s new Chief Executive in May 2018, bringing with her a wealth of experience. There is a warm round of applause as Cynthia takes to the stage to thank all of those involved in making the last few years a great success.

That’s it for the live blog, hopefully you enjoyed hearing about the meeting and we will be back again next year!

15:15 – Panel Discussion: Is wellbeing missing the target? The current trend for improving mental wellbeing has significant support from the government but is this wider focus coming at the expense of targeted help for those that need it most?

We close the MQ Science Meeting with a panel discussion, chaired by Simon Wessely from Kings College London. He is joined on stage by Dr Martin Knapp (London School of Economics, UK), Ilina Singh (University of Oxford, UK), Catherine Newsome (Department for Education, UK Government) and Karina Chopra (Medical student and service user). You can follow the discussion for yourself using the live stream below:

If you’d sooner read updates, no need to fret as we will be taking you through the best points from our discussion right here on the live blog.

Catherine gets the ball rolling by highlighting the Children and Young People’s Mental Health green paper on children and young people’s mental health, which sets out the government’s ambition to ensure that those who need it are able to access the right help for their mental health. She calls for more suggestions and engagement in the project, directing people towards the webpage that allows people to get involved.

Discussion moves on to the financial effects of extending preventative programmes to all. Economic consequences have to be taken into account and the panel asks if large scale preventions make financial sense? Mental health funding has gone up overall, but the amount spent on targeted services for people with severe mental health problems has declined. Is this the best way to allocate our resources? Send us your comments through Twitter, we’re always keen to hear your thoughts!

An interesting point from the fantastic @Mental_Elf on Twitter, who has been with us for the duration of our meeting. Are universal approaches even effective?

A final question from the audience – what is the role of digital interventions in the future of preventative medicine? The panel is cautious on the subject, emphasising that it is very hard to substitute for human interactions, especially in relation to therapy.

That concludes the panel discussion, with far more points than we have been able to include in the blog. If you want to listen to the entire discussion, follow the link to our twitter page above and you'll be able to catch up on all that's been said.

14:30 – Keynote Three: Prevention in mental health, a train we should not miss. Not again.

Professor Celso Arango (Complutense University of Madrid, Spain)

Good afternoon and welcome back to the final session of what has been a fantastic meeting. Our final keynote address comes from Professor Celso Arango, who is speaking today about the feasibility of preventative interventions in the treatment of mental illness.

Celso sets the scene for his talk with a quote from the 19th Century social reformer, Frederick Douglass: “It is easier to build strong children than it is to repair broken men”. Would it be better to treat the possible causes of mental illness in early life, before they have the opportunity to develop into serious health issues?

Celso goes on to talk about the success of preventative approaches in other disciplines of medicine – including cancer, diabetes and cardiovascular disease. Why isn’t the mental health community following the lead of these other research fields? This is the figurative train that Celso is referring to in the title of his talk and he emphasises that we can ill afford to miss out on the opportunities that preventative medicine may be able to provide.

Next, Celso introduces the critical early stages of brain development as prime opportunities for preventative interventions. He describes how in some cases, starting treatment when someone is 20 or 25 could already be too late to have significant effects on the brain as it has more or less reached its final size. This so called ‘therapeutic window’, where an individual is the most responsive to treatment, is where Celso thinks our efforts should be focused.

Echoing the messages of Thalia Eley from earlier today, Celso discusses some genetic factors that can be used to provide an early indicator of mental illness before symptoms are first observed. To demonstrate this point, he describes a study that focused on a group of people with genetic factors that lead to a very high risk of psychosis. Over 90% of the individuals in this group went on to develop a mental illness. Should we pre-emptively treat people in this high risk population even if they are not currently displaying signs of ill health?

For the remainder of his talk, Celso provides a series of examples to demonstrate the potential of mental health interventions in high risk populations. The data presented is convincing and I’m sure that we will be hearing plenty more on the subject in our upcoming panel discussion.

13:15 – Discussion

Straight into a panel discussion with our three speakers and there's plenty of interest in the ethical talking points raised during Camillia’s talk. A recurring theme – what are the implications that arise if we don’t intervene? Is it ethical to allow someone to become unwell if preventative treatments are available? This is clearly an incredibly difficult topic to find a concrete answer to and it is apparent that the needs of the individual receiving the treatment have to be respected.

Paul Ramchandani is asked if paternal depression can influence childhood development in the same way that maternal mental health problems can have negative effects on a child. Paul responds by describing how depression in both mothers and fathers can influence their offspring but the mechanisms responsible for this effect are complex and still need to be pieced apart. A detailed blog on this subject can be found on the Mental Elf website, for those looking for further reading.

Following the announcement of the poster prizes (keep an eye out for interviews with our winners in the MQ podcast soon!), we break for lunch. Plenty to discuss over our sandwiches, we’ll be back in an hour or so to take you through the final session of the day.

12:40 – The ethics of prevention and early intervention: some critical reflectionsDr Camillia Kong (University of Oxford, UK)

Dr Camillia Kong opens her talk by promising it’ll be provocative. Camillia is a philosopher by training and currently works as an ethicist at the University of Oxford. Today, Camillia will be speaking about the ethical implications associated with early interventions in the context of mental health.

Camillia introduces psychiatric genomics, a discipline which uses DNA samples and genetic data to identify the individuals that are more likely to develop mental health problems. Is it ethical to study DNA to guide preventative therapies? Could this approach increase stigma in the context of mental health?

Camillia describes the ways that stigma can affect those with mental illnesses. Stigma can isolate individuals and can cause them to be discriminated against for being ‘different’. Camillia suggests that genetic testing should be approached with caution and that if care is not taken, such approaches may inadvertently cause stigma against those with mental health conditions to increase. How would this work? Camilla introduces a number of factors, including the observation that focusing on a person’s DNA may reinforce the notion that those with mental health problems are inherently ‘different’ from everyone else.

It is also important that we respect the way that people view their mental illness and understand that some people don’t want to be tested or treated. Camilla explains:

“An ethical approach to early intervention will have to walk a delicate balance between accepting and respecting individuals who might see their disorder as part of themselves and alleviating potential future distress and suffering.”

Camillia’s talk provides plenty of interesting concepts to think about as we go forward and provides a stark reminder that for all of our research, the thoughts and opinions of those suffering from mental illness must be at the forefront of all of our decisions.

12:10 – What you lose on the swings: using randomised controlled trials to look at pathways to prevention;

Professor Paul Ramchandani (University of Cambridge, UK)

Our next speaker is Paul Ramchandani, who is the LEGO Professor of Play in Education, Development and Learning at the University of Cambridge.

Paul’s begins his talk by introducing the effects that maternal depression around the time of birth can have on a child as it ages and develops. Around 10-15% of pregnant women experience severe distress and anxiety. This is thought to have wide ranging consequences on children – influencing factors as varied as birthweight, behavioural problems and depression.

“We know that women who have high levels of stress during pregnancy are more likely to have anxiety and depression after they give birth," Paul Ramchandani

This is a compelling correlation, but how can we uncover the cause of this effect? Can we be sure that a mother’s mental illness directly leads to the problems that are seen in a child? Paul introduces some of the biological changes that happen during maternal depression. One well-characterised example is an increase in stress hormones in the mother, which are thought to influence the developing foetus.

Paul goes on to discuss a prospective clinical trial that may be able to determine the benefits of reduced anxiety in expectant mothers. Known as the ACORN study, this approach works with midwives and psychologists to support pregnant women with the aim of reducing their mental health problems. It’s too early to comment on the final outcomes of the trial as it is still in progress but Paul describes how the approach has been received well by mothers and early signs are promising.

11:40 – How neuroscience is helping to motivate a preventative psychiatry approach to mental health: latent vulnerability and the impact of childhood maltreatment

Dr. Eamon McCrory (University College London, UK)

A quick break for some tea, coffee and snacks (the blueberry muffin my personal favourite) and we’re straight into today’s second symposium: ‘The case and challenges for early intervention and prevention’. Our first speaker on this topic is Eamon McCrory, who starts his talk by discussing the long-term impact that abuse and neglect can have on children’s mental health – often lasting for many years after the initial event. These long-term consequences are complex, with mental health problems, decreased attainment, decreased economic prosperity and poor physical health all associated with adverse experiences in early life.

Eamon describes how children can adapt to early chaotic, unpredictable or violent homes in ways that enable them survive and cope. However, the biological and psychological changes associated with these adaptations can come at a high price. Some children adapt to ‘fit’ atypical and disturbed environments in ways that are not helpful when they go out into the world to make friends, learn and develop as adults. Children with adaptations of this kind are referred to as possessing ‘latent vulnerability’, which may be associated with mental health problems in later life.

Despite this, not all children with a poor start in life end up with depression and some children are resilient to childhood trauma. Exactly why some children thrive whilst others struggle remains unknown.

So, what can be done to identify signs of latent vulnerability in infants? Eamon goes on to show brain imaging data that demonstrates altered neural activity in a group of children that had experienced neglect in their early years of life. The changes that Eamon and his team observed were similar to the changes seen in traumatised soldiers and can potentially be used to identify vulnerable children at risk of developing depression as they age.

Eamon explains how an increased understanding of latent vulnerability in children could be used in the future to identify children at the highest risk of developing mental illness. This will provide opportunities to provide preventative intervention that can offset the likelihood of mental health problems before they emerge – helping them get back on track with their lives.

Neurocognitive mechanisms such as overgeneral memory and altered threat processing mean maltreated children may be less able to elicit and sustain the social support they need to prevent future mental health problems. Eamon McCrroy #MQScienceMeeting

11:00 – Questions

We finish up the mechanisms and vulnerability of treatment symposium with a panel discussion as Thalia and Paul join Ian on stage.

Plenty of discussion, including questions on a phone app Thalia is hoping to develop, some clarification from Paul on the use of Methionine as a dietary supplement and a few points directed at Ian concerning the potential of histone serotonylation as a drug target.

When questioned on the reversibility of serotonin based histone modifications, Ian describes how the picture is currently unclear. This is an important point however, as if the process of serotonylation can be reversed, it may be possible to develop drugs that can interfere with this process and alleviate depressive symptoms. However, it is very hard to develop medications without a full and detailed understanding and Ian describes how he is currently unable to make a concrete statement on the subject.

A question from Professor Michael Owen next – how well do the stressful situations we develop in the lab recapitulate human traumas, like those associated with famine and war.

The panel acknowledges how difficult it is to study the brains of traumatised humans in the detail required for many of their studies. However, they do describe a number of efforts to investigate the human response to trauma, highlighting ongoing studies that analyse the blood of soldiers following exposure to conflict and the brains of firefighters that attended the 9/11 attacks in New York.

Dr. Ian Maze (Icahn School of Medicine, USA)

For our next talk, we stick to the theme of genetics and DNA as Dr Ian Maze takes to the stage. Ian starts his talk by introducing major depressive disorder, or MDD.

Ian describes MDD as a chronic syndrome that affects millions of individuals worldwide. Despite this, few advances have been made in its treatment since the discovery of tricyclic and monoamine oxidase inhibitor antidepressants over six decades ago. Furthermore, only half of people will display a full recovery following treatment with one of these drugs.

Ian’s research group is interested in a chemical modification that happens in the brain called “histone serotonylation”. Histones, a group of proteins that spend their time bound to DNA, are capable of influencing gene expression and Ian explains how histones could be involved in certain genetic changes that occur in the brains of people with MDD. Ian goes on to introduce serotonin, a separate molecule that plays an important role in the brain, where it has been implicated in the regulation of mood.

In certain situations, a molecule of serotonin can be fused to a histone in the brain and when this modification occurs, it can cause certain genes to be switched on and expressed.

When Ian looked at the brains of people with MDD, or animal models of depression, a difference in histone serotonylation was observed. Whilst Ian is quick to stress that it is still early days, he is excited about histone serotonylation as a potential drug target. Whilst it can take many years for a drug to be developed and reach the market, any advances in the treatment of depression are surely welcome.

Ian Maze: Specific DNA bound proteins in human cells can be chemically modified by the "neurotransmitter” serotonin, leading to changes in the ways in which our genes are expressed in the brain; this process is perturbed in depression #MQScienceMeeting

10:00 – Mechanisms of vulnerability and treatment.

Professor Thalia Eley (Kings College London, UK)

Next up is Thalia Eley, Professor of Developmental Behavioural Genetics at Kings College London. Thalia is a pioneer in the emerging field of therapygenetics and she starts her talk with an introduction to this exciting new discipline.

First, Thalia offers a simple yet thought provoking question to the audience - why do only 50% of people respond to psychological treatments for mental illness?

Thalia explains how therapygenetics aims to use genetic information to identify the people that are most likely to benefit from a given psychological treatment. Depression and anxiety are conditions of particular interest to Thalia’s research team and she uses statistical data to justify her interest in these two conditions:

“Anxiety and depression affect roughly one third of people, why that number is so high is poorly understood,” says Thalia. “Although MQ is doing a fantastic job at improving our understanding, we still need to do everything we can to understand how these conditions come about and how we should treat them.”

To illustrate the power of therapygenetics, Thalia discusses the results of a trial she recently conducted. First, her research team developed a genetic analysis that can be used to identify children that are particularly sensitive to environmental influences – things like peer group isolation or bullying for example.

With this test, Thalia was able to show that the children that are most sensitive to their environment do especially well when they are provided with one-to-one treatment with a therapist, but much less well when their treatment is provided by their parent with the help of a book. Without the genetic testing, it is impossible to predict which children will respond the best to each treatment.

09:30 – Effects of early life stress and nutrition on later brain plasticity and disease vulnerability

Dr. Paul Lucassen (University of Amsterdam, NL)

We start the day with Dr. Paul Lucassen, who is the first of three speakers in this morning’s symposium on the mechanisms of vulnerability and treatment.

Why is it that a ‘bad childhood’ can often have long-lasting effects on a person’s brain? What are the key elements of the early life environment that influence later disease vulnerability?

Paul introduces a series of research models that he uses to study the long-term effects of stress in the young.

Paul finds that early life stress during the first week of life ‘programs’ the brain in a way that causes changes in learning and memory several months later. Paul also spoke about the way that stress in the first weeks of life can alter specific aspects of brain structure and function, in particular, the capacity of the adult brain to form new neurons, a process known as 'adult neurogenesis’.

So, can anything be done to rectify the negative effects of stress in the early years of life? Paul presents some interesting results. We show that specific diets given to the young, or during later developmental periods, can improve and rescue some of the deleterious effects caused by early life stress.

Fascinating mouse work by @LucassenPJ exploring associations between various prenatal and postnatal stresses. Whilst early stress isn’t good for neurogenesis, it does prepare pups to learn better in fear conditioning paradigm. Supports match-mismatch hypothesis @MQmentalhealth

Great talk by Paul Lucassen finding diet can reduce negative effects of early stress in mice at #MQScienceMeeting relevant to #MooDFOOD currently testing if diet prevents depression in adults perhaps extend to depressed mothers?

09:15 – Welcome

Hello and welcome back to the second day of our live blog covering the 2018 MQ Mental Health Science Meeting. The auditorium is starting to fill up and we have a great list of speakers to look forward to, here is a list of today’s highlights.

Thursday 1st February 2018

16:30 – NIHR i4i Mental Health Challenge Award

And now for a first at the Mental Health Science Meeting, Martin Hunt from the National Institute for Health Research and Lord O’Shaughnessy will close the day with the awarding of a new funding award!

MQ chief executive Cynthia Joyce takes to the stage to open the prize giving ceremony and introduce the NIHR i4i award. Cynthia describes how mental health research still lags behind other areas of science. “Only about 6% of UK research spend is dedicated to mental health and it’s the same in practically every nation,” explains Cynthia. “Are we putting enough effort into research and what can we do to change this?” She asks. One solution is the introduction of new funding awards, which provide researchers with the resources to tackle the biggest issues in mental health research.

Martin Hunt is next to the lectern. Martin describes how the i4i award is focusing on new technology, with the ultimate aim of identifying new ways to identify, diagnose and treat mental health conditions. So, what makes the i4i award different to other sources of funding. Well, this year’s funding is employing a ‘winner takes all approach’. This means that the most promising and ambitious project proposal will receive the full backing of the NIHR’s support, which this year comprises just under £4 million of capital funding.

Lord O’Shaughnessy joins Martin to announce the results and the winner is Daniel Freeman from the University of Oxford, who will use the prize money to investigate the use of virtual reality technology in the treatment of schizophrenia and psychosis.

Daniel is now on stage to accept his award. “We’re excited as this funding will allow us to really transform the way we support people with severe and debilitating mental health conditions” Daniel says.

Currently, over 200,000 people with schizophrenia receive treatment for their condition, at a cost of around £7.2 billion. Despite this, current treatments have a number of limitations. People with schizophrenia are less likely to leave the house for example – withdrawing from society as a result. They have reduced social circles and this is thought to contribute towards a shocking statistic - the average life expectancy of those with schizophrenia is around 14 years lower than that of their healthy peers.

Freeman explains how immersive virtual reality can be used to overcome the fears that may be preventing people with psychosis from engaging with the outside world. Using virtual reality technology, patients can be exposed to a difficult situation, such as a busy shopping centre or a crowded underground train, in the safety of a clinic or their home. Importantly, preliminary findings appear to show that the VR technology works, with those that receive the VR intervention responding as well as the best currently available therapeutic approaches.

The i4i award will be running again next year and they are looking for the best and brightest research teams to develop the most innovative technology to tackle challenges in mental health. Think you’ve got a winning idea? Head to their website for more information.

Our final talk of the day comes from Judy Garber, Professor of Psychology and Human Development at Vanderbilt University in Nashville Tennessee. Today Judy is presenting her findings from a recent trial investigating the effects of a cognitive-behaviour program (referred to herein as CBP) on children at high risk of developing depression.

As part of her trial, Judy selected over 300 13-17 year olds who were selected as they were deemed the most likely to develop depression. These teenagers were selected from four sites around the USA, before the group was randomised and half were provided with the CBP program whilst the other half proceeded with their usual care.

Judy Garber: why isn't cognitive behavioural prevention (CBP) even better (>20% still got depressed)? Many moderators of effect, including that CBP prevented depression *only* if parents were not depressed at baseline #MQScienceMeetinghttps://t.co/r8RizVb7nv

So, how do you determine which children are at the highest risk of developing depression? For the purposes of her trial, Judy decided to use a relatively simple selection criteria by focusing on teenagers with parents that have been diagnosed with depression and teenagers that have had been affected by depression in the past. Children in the test group were provided with around six sessions of therapy every 8 weeks, before follow-up appointments were provided every six months.

Following their intervention, participants were then followed up and their depressive symptoms were determined. At 9 months (the end of the therapy program), the first differences could already be observed, with those that received the therapy less likely to have experienced a depressive episode.

What about the longer-term outcomes? A common concern associated with intervention based trials is that there may be an instant improvement but this could wear off over time. With Judy’s CBP approach, this doesn’t appear to be the case and 33 months after the treatment was delivered, an even bigger difference was observed between those that had received the targeted intervention and those that had not.

Interestingly, Judy realised at this point that the teenagers that responded the best to treatment were the ones with parents that weren’t actively depressed at the time of intervention. In contrast, if a high-risk teenager had a depressed parent at the time of therapy, they were much less likely to respond.

Judy finishes her talk with a question: Are we there yet, and if not, what’s next?

This intergenerational aspect touches on a recurring theme from today’s speakers, should we be treating parents as well as children to improve the wellbeing of the family as a whole? Many of the issues raised in Adrian Falkov’s earlier talk resonate with Judy’s findings today – I’m sure there will be plenty of lively discussion between the two of them over a drink at the poster session later!

15:00 – Discussion

Our discussion for the final symposium is under way as the three speakers take comments from the audience.

Our first question is from the session chair, Professor Felicity Callard. How well can information gathered from different countries be transferred? Can we take information gathered from studies in Norway and apply them to Northern Ireland?

All of the speakers appreciate the huge differences that exist between cultures. Sarah-Jayne Blackmore describes the bias that exists in many of our datasets. We know an awful lot about brain development in the Netherlands, the United Kingdom and the USA but our understanding of the situation in countries with less of a focus on medical research is limited.

Both Vladimir Carli and Adrian Falkov are confident that their therapeutic approaches have the potential to be applied around the world. However, they both admit that a major limitation that currently exists is the focus that is placed on English speaking countries. More work will be needed to bring the best interventions to the global community.

Sir Phillip Campbell, Editor in Chief of the journal Nature and MQ Trustee, asks the next question. Is there a correlation between social media usage in adolescents and mental health problems?

Sarah Jayne Blakemore replies by stressing that the data required to answer that question is not currently available. She does however highlight reports on screen-time in adolescents. In these studies, the highest wellbeing was seen in those with moderate screen usage, whilst the lowest wellbeing occurred in those with either very low or excessive screen-time. This goes against the idea that screens and social media are always a bad thing.

Vladimir Carli agrees that we need more information on the subject but does highlight the impact that social media and mobile technology can have on sleep, which has been shown to have profound effects on wellbeing.

Finally, Adrian Falkov highlights the potential opportunities for intervention that mobile phones provide. We’ve reached the point where the majority of children have access to a handheld device - how can we use this to our advantage?

“Social media is here to stay,” says Adrian. “The quicker we can understand and use that fact to our advantage the better”.

Vladimir begins his talk by discussing the devastating effects of adolescent suicide and the steps being taken to reduce suicide attempts in the young. Vladimir believes that evidence-based prevention programmes are a promising avenue of research, which he hopes will be able to reduce the rates of suicide and mental health problems amongst the young.

In recent years, Vladimir has been involved in a randomised controlled trial investigating the efficacy of school-based mental health promotion programmes for suicide prevention. The result of this study show that a 5-hour intervention program delivered to the entire classroom was significantly effective in preventing youth suicide. The data presented is striking, with suicide attempts reduced by 50% amongst those that have received the intervention.

So, what does the 5-hour intervention entail? Vladimir describes how the programme, known as the Youth Aware of Mental Health (YAM) approach, integrates role-play, reflection and dialogue to help young people reflect on complex mental health problems such as stress, bullying, depression, and suicide. The design of YAM aims to change student perceptions of mental health and improve their coping skills and management of adverse life events.

Another important aspect to consider is teacher training. Can teachers be trained to recognise the symptoms of severe depression and what can they do to reduce adolescent suicide? Vladimir describes an intervention he calls QPR – which stands for Question, Persuade, Refer. In this program, information on suicidal behaviour, warning signs and support systems was provided directly to teachers. In general, the QPR program was received well by teachers and schools were keen to provide the training to their staff.

Interestingly, the QPR study saw that the teachers who are most satisfied with their work conditions and well-being were more likely to help their pupils. Could the wellbeing of teachers improve the wellbeing of their pupils? This is an interesting concept, that requires further research.

14:00 – The Family Model – a brief family focussed intervention for parents with mental health problems and their children.

Dr. Adrian Falkov (Northshore Kidspace, Sydney, Australia)

Sticking with the theme of childhood and adolescence, our next speaker is the child, adolescent and family psychiatrist Dr Adrian Falkov. Today, Adrian is talking about The Family Model, a therapeutic framework that aims to integrate the family of people suffering from mental illnesses into their treatment regime.

Adrian begins his talk by reading a poignant letter from Heide Lloyd, one of the patients that has benefited from his family focused method of treatment. In her letter, Heide outlines her experiences as a mother with mental illness, and discusses the challenges that both her, her children and her grandchildren have faced as a result.

Focusing on the children of parents with mental illness, Adrian describes some of the benefits that arise when both generations are involved in a treatment plan. If a parent sees an improvement in their symptoms, for example, the wellbeing and safety of their child is likely to increase. Conversely, if a child better understands the condition of their mother or father and receives targeted support, it can reduce the burden that is placed on the parents.

Adrian Falkov’s talk will help inform/enhance participants knowledge & understanding of The Family Model; a tool showing promise as a brief intervention in clinical settings for improving communication btwn parents & children about their MH challenges #mqsciencemeeting

Adrian’s talk provides a fascinating perspective from the clinic and his anecdotes and real-life examples have captivated the auditorium. Hearing the stories of patients reminds us of the ultimate goal of all of our research – to improve the health of those afflicted by mental illness.

13:30 – Adolescence: A sensitive period of brain development?

Professor Sarah-Jayne Blakemore (University College London, UK)

With everyone well-fed and back from lunch, we are ready to get going with this afternoon’s action. We dive straight into our second symposium - ‘Development and Support of the Social Self’.

Our first speaker is Sarah-Jayne Blakemore, Professor of Cognitive Neuroscience at UCL. Sarah starts her talk by asking, what behaviours do we associate with teenagers? One answer that may spring to mind is an increase in risk-taking behaviours.

Research confirms the observation that adolescents are indeed more likely to take risky behaviours than adults – things like smoking, drinking or driving dangerously, for example. Furthermore, Sarah describes how teenagers are far more likely to undertake risky behaviours when they are in the company of their peers.

Why are teenagers more risky when in groups? Sarah suggests that it could be explained by an increased susceptibility to social influences in our younger years. Through a series of detailed and elegant studies, Sarah and her team have been able to show that as we age, we are less likely to allow the opinions of others to influence our decisions and this correlates with a decrease in risky behaviour.

I've heard @sjblakemore a bunch of time and I LOVE her description of adolescence as ending "at the age at which an individual attains a stable, independent role in society” Cue everyone in the #MQScienceMeeting audience to wonder if they've reached that milestone yet 😬

Could changes in brain structure explain the behavioural changes we associate with our adolescent years? After all, our bodies change significantly during this critical period. Using brain scanning data from a variety of individual over the course of many years, Sarah has observed a number of structural changes in the aging brain. These changes could make adolescence a sensitive period of development, particularly when it comes to navigating the complex social pressures we tackle as teenagers.

12:35 – Lunchtime break

At the end of a fascinating first morning we take a break for lunch. As the speakers and the delegates head off to the terrace for food and discussions, here are the highlights from the session.

We started the day with optimism, as both Sophie Dix and Jeremy Hall discussed their excitement for the future of mental health research.

This was followed by an insightful and entertaining keynote talk from Prof. Sir Michael Owen on the benefits and limitations of genetics in mental health research and a fascinating symposium on the ‘Pathways to Health and Disease’.

We’ll be back after some food to cover the rest of the afternoon’s action!

Sophia begins by talking about the tendency of Bipolar Disorder to run in families – close relatives of people with the disorder are more likely to develop a similar condition themselves. However, the majority of these “high risk” individuals remain free of mental illness and Sophia set out to identify some of the factors that help these people to remain healthy.

Sophia believes that there are a number of factors that could contribute towards resilience in relatives of people with Bipolar Disorder, both psychological (e.g. good coping skills) and social (e.g. supportive relationships). However, today Sophia focuses on the biological basis of resilience and reports a number of interesting findings her team have made by studying the brains of people with Bipolar Disorder and their families.

Using advanced imaging technology, Sophia could see that the brains of resilient relatives had some unexpected structural differences. Specifically, the cerebellum, a region of the brain involved in “balancing” mood and movement, was larger than average. She could also observe that the “default mode network”, a group of brain regions that are often described as the functional backbone of the brain, displayed a higher degree of activity in resilient individuals.

Sophia believes her findings show that the brain can adapt its structure and function in the face of heightened genetic risk for Bipolar Disorder. In the future, this line of research may also make it possible to find markers of disease and resilience.

Next up is Professor Rebecca Elliott who will be talking about depression. Rebecca’s research focuses on understanding the neurobiological basis of emotional, motivational and social processes, particularly in the context of mental illness.

Rebecca starts her talk by discussing emotions and the way that people respond to emotional situations in different ways. Rebecca discusses a series of studies she has been involved in that look at the responses of people to simple emotional stimuli, such as pictures of happy and sad faces or emotional words. Rebecca could show that healthy people display a bias towards “happy” stimuli, whilst those with a history of depression tend to respond more readily to “sad” words.

Rebecca introduces childhood trauma as a major risk factor associated with mental health problems. Could early life stress influence a persons ability to process emotions in later life? Rebecca’s research shows many promising correlations between stressful life events and emotional processing in later life, providing a new link between traumatic events and mental health.

10:45 – Prefrontal-hippocampal ontogeny in health and disease: a story of right communication

Our next speaker is Professor Ileana Hanganu-Opatz who will be kicking off our first symposium on ‘Pathways to Health and Disease’.

Ileana’s research group studies the very early stages of brain development and hopes to understand how subtle changes in these crucial early stages can lead to mental health problems in later life.

Ileana introduces the notion of brain rhythms, synchronous pulses of electrical activity that occur when two regions of the brain interact with each other. In babies and young children, brain rhythms arise when a child is touched or hears sounds like music. Could these regular pulses be involved in the development of the brain?

For the rest of the talk, Ileana focuses on two specific areas of the brain - the prefrontal cortex and the hippocampus. She explains that in some people with mental illness, these two brain regions are unable to communicate with each other properly, which can lead to issues with memory and attention. Suspecting these communication issues start long before a person actually becomes unwell, Ileana and her research team set out to uncover exactly when in life these problems first occur.

Using mice with symptoms that mimic human mental illnesses, Ileana was able to show that disrupted brain rhythms and poor communication between the hippocampus and the prefrontal cortex occurred directly from birth. These communication issues are the first step towards cognitive problems in later life, providing new insights into the brain as it develops.

Our first speaker is Professor Sir Michael Owen, Director of the MRC Centre for Neuropsychiatric Genetics and Genomics at Cardiff University. Michael has worked on the genetic basis of mental illnesses for over 20 years, receiving a knighthood in 2014 for his work in neuroscience and mental health.

Michael starts his talk with a simple question: why is genetics so important?

According to Michael, there are many advantages to studying a person’s genes and DNA. Genetics allow you to gain information on the brain, which is a complex and inaccessible organ. Many mental illnesses run in families, suggesting that genes may be playing an important role. Genetics has also identified many novel drug targets and increased our understanding of the underlying causes of mental health conditions.

Michael goes on to introduce a key concept in his talk - single nucleotide polymorphisms or SNPs. SNPs are small genetic changes that exist between different people in the population, and Michael describes how different versions of certain SNPs in a person’s DNA can be correlated with an increased risk of developing schizophrenia.

Sounds simple? Surely once you find a SNP you can predict whether or not a person is going to develop schizophrenia? According to Michael, it’s not quite as easy as this. As more and more data is produced, it is becoming increasingly apparent that thousands of SNPs affecting hundreds of genes act together to cause mental health conditions to develop. Moreover, many of the genes that have been associated with schizophrenia have also been linked to a variety of other mental health conditions, like depression or bipolar disorder.

"I used to come to meetings and they'd say why haven't you found anything? And now they say, you're finding too many genes! The question is when do you stop?" Michael Owen

“People talk about finding a simple genetic test for schizophrenia, or bipolar disorder. I have a large collection of hats and I’ll eat them all if this happens any time soon!” says Michael.

Mental illnesses are vastly complex and increasing our understanding of the genetics of mental health poses an exciting challenge for the future of research.

09:55 – Welcome

There’s a lively buzz in the auditorium as over 200 researchers stream in for this morning’s first session. Dr Sophie Dix, MQ’s Director of Research, takes to the stage to open the meeting. Speaking to a packed auditorium, Sophie talks about the current state of mental health research.

“Its an exciting time for mental health research,” describes Sophie. “We have seen the public, politicians and celebrities getting behind the cause”

Jeremy Hall, who has been heavily involved in the organisation of this meeting, is next up. Jeremy introduces this year’s focus – risk and prevention. Echoing Sophie’s excitement at the current state of mental health research.

“We have at our hands many of the potential tool for prevention and intervention” explains Jeremy, before introducing our first speaker, Professor Sir Michael Owen.

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